Wang Yi-Jie, Huang Chien-Peng, Hong Zhi-Jie, Liao Guo-Shiou, Yu Jyh-Cherng
Department of Surgery, Tri Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Department of Pathology, Tri Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
World J Clin Cases. 2023 Mar 6;11(7):1521-1527. doi: 10.12998/wjcc.v11.i7.1521.
Invasive breast carcinoma with osteoclast-like stromal giant cells (OGCs) is an extremely rare morphology of breast carcinomas. To the best of our knowledge, the most recent case report describing this rare pathology was published six years ago. The mechanism controlling the development of this unique histological formation is still unknown. Further, the prognosis of patients with OGC involvement is also controversial.
We report the case of a 48-year-old woman, who presented to the outpatient department with a palpable, growing, painless mass in her left breast for about one year. Sonography and mammography revealed a 26.5 mm × 18.8 mm asymmetric, lobular mass with circumscribed margin and the Breast Imaging Reporting and Data System was category 4C. Sono-guided aspiration biopsy revealed invasive ductal carcinoma. The patient underwent breast conserving surgery and was diagnosed with invasive breast carcinoma with OGCs, grade II, with intermediate grade of ductal carcinoma in situ (ER: 80%, 3+, PR: 80%, 3+, HER-2: negative, Ki 67: 30%). Adjuvant chemotherapy and post-operation radiotherapy were initiated thereafter.
As a rare morphology of breast cancer, breast carcinoma with OGC occurs most often in relatively young women, has less lymph node involvement, and its occurrence is not race-dependent.
伴有破骨细胞样间质巨细胞(OGCs)的浸润性乳腺癌是一种极为罕见的乳腺癌形态。据我们所知,描述这种罕见病理的最新病例报告发表于六年前。控制这种独特组织学形成发展的机制仍然未知。此外,伴有OGCs的患者预后也存在争议。
我们报告一例48岁女性病例,该患者因左乳可触及、生长性、无痛性肿块约一年就诊于门诊。超声和乳腺X线摄影显示一个26.5 mm×18.8 mm不对称、分叶状肿块,边界清晰,乳腺影像报告和数据系统分类为4C类。超声引导下穿刺活检显示浸润性导管癌。患者接受了保乳手术,被诊断为伴有OGCs的浸润性乳腺癌,II级,原位导管癌中度分级(雌激素受体:80%,3+;孕激素受体:80%,3+;人表皮生长因子受体2:阴性;Ki67:30%)。此后开始辅助化疗和术后放疗。
作为一种罕见的乳腺癌形态,伴有OGCs的乳腺癌最常发生于相对年轻的女性,淋巴结受累较少,其发生与种族无关。